Question:My son is a freshman away from home at college. He fell from a ladder and dislocated his collarbone. He tells me he had a 'closed reduction' and he's okay. What does this mean?
Reducing a dislocation of any joint means the joint is put back in place or 'relocated.' A closed reduction suggests the medical person who treated him was able to get it back in place without surgery.
Sometimes it's just a matter of putting the patient in just the right position and the bone will slip back in place. For example, one way to relocate the collarbone (clavicle) to the sternum is to lie down on the back with the dislocated side on the edge of a table. A sandbag is put between the shoulders. The arm is brought out to the side and pulled out gently. The sound of a "pop" occurs when the clavicle goes back into place.
There are several other ways to relocate this joint. If that doesn't work then surgery or open reduction may be needed. The clavicle is lifted up and put back in place. If it stays there without slipping down the incision is closed and the patient is immobilized in a special sling to hold it in place.
If the clavicle keeps slipping out of place then more extensive surgery may be needed. Your son should be advised not to do any lifting for the next six weeks until the joint is fully healed. Strenuous upper body exercises such as push-ups or pull-ups should also be avoided.Nicholas Gove, MD, et al. Posterior Sternoclavicular Dislocations: A Review of Management and Complications. In The American Journal of Orthopedics. March 2006. Vol. 35. No. 3. Pp. 132-136.
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